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In relation to the effectiveness of treatments with medicinal water, several high-standard publications by Hungarian authors – easily meeting the requirements of “evidence-based medicine” – have been published in recent years in Hungarian and foreign scientific reviews. (1,2, 3, 4,5) Several important publications have also dealt with the complex treatment of locomotive disorders. (6, 7, 8, 9)

According to the domestic and Central European medical approach, complex treatments which apply the entire arsenal of physiotherapy are much more effective than monotherapy. There are therefore no health resorts or institutions in Hungary treating diseases with the exclusive application of a single – no matter how effective – local curative factor. There are, for example, no mud or irrigation health institutions where every disorder is treated with mud packs, or by rinsing all bodily orifices with medicinal water (e.g. in the event of lesions of the accessory nasal cavities or gastro-intestines, or gynaecological diseases).

We deemed it expedient to investigate the status of patients participating in two and three-week cures at domestic spa hotels (spa guests) upon arrival and departure, and to ascertain their subjective complaints and their opinions relating to the efficiency of the treatments.

We involved the spa guests of Danubius Health Spa Resort Hotel Margitsziget, Hotel Helia, the spa operating in the same building as Danubius Hotel Gellért, the Spa Hotels Hévíz and Aqua, and the Spa Hotels in Sárvár and Bük in the survey.

The data of 94 patients with coxarthrosis were computer-processed in total. The patients were treated between December 2007 and May 2008 at the above-mentioned institutions.Every patient received every treatment necessary for his/her condition and his/her complaints (spa treatments, hydrotherapeutic procedures, mud treatments, medicinal gymnastics, electrotherapy, etc.).Spa treatments were performed using certified medicinal water at all locations.From the outset, we excluded from the survey patients who had undergone operations involving hip or knee-joint prosthesis, as well as those restricted in their motion due to their cardiac condition or spinal complaints.

We compiled the assessment form based on the documentation recommendations that Csermely (10) proposed for the qualification of medicinal water.

The forms were completed during the first medical examination and on the last treatment day; they were always completed by the same person.

The patients came from eight countries:

HOME COUNTRY

WOMEN

MEN

TOTAL

Grand Total:

59

35

94

Germany

32

25

57

Hungary

12

3

15

Austria

7

3

10

Switzerland

3

2

5

Russia

3

0

3

USA

1

1

2

Australia

0

1

1

Israel

1

0

1

German citizens traditionally have made up a decisive majority of patients receiving complex treatment, although their number has decreased in recent years in the absolute sense due to the restrictions of domestic insurance subsidies, as well as the economic recession.

The proportion of men (35 people) to women (59 people) represents the typical ratio split of spa guests, since, according to general experience, women take more care of their health than men and are also willing to spend money on it.

There was little difference between the average age of men and women (men: 67.3 years, women: 67.5 years).The highest average age was found in patients at the two hotels in Hévíz (men: 70.14 years, women: 70.43 years).At the Budapest hotels, the average age of men was 62.5 years and the average age of women 65.7 years; this proportion was almost identical at the hotels in Sárvár and Bük as well.

Of the 94 patients examined, 58 received a three-week treatment and 36 received a two-week treatment. The three-week cure was primarily taken by the Germans (20 women and 13 men) and the Hungarians. The latter group all received a three-week treatment.Contrary to our expectations, we found no significant discrepancy between the therapeutic results of those having participated in a two-week or three-week cure, thus we – on assessment – merged the two groups.There was also no significant difference between the results achieved amongst the respective establishments. This fact confirmed our conviction that improvement was independent of the spa hotel where the patients received treatment.

18% of men and 32% of women had a bilateral hip process. Unfortunately, we could only rely on physical examinations, measurable data (walking time, distance of pace, etc.) and the patients’ complaints when completing the forms, because most of the patients did not bring an X-ray photograph or medical report with them.

During the assessment, we compared the data of the respective examined parameters both prior to and subsequent to complex treatment.

We recorded alterations in five sorts of pain sensations, based on the patients’ subjective opinions.

(PT: prior to treatment; ST: subsequent to treatment)

PT AT REST

PT PCS

ST AT REST

ST PCS

none

49

none

63

mild

25

mild

25

medium

16

medium

6

strong

4

strong

0

PT UPON MOTION

PT PCS

ST UPON MOTION

ST PCS

none

1

none

14

mild

29

mild

46

medium

39

medium

33

strong

25

strong

1

PT UPON START-UP

PT PCS

ST UPON START-UP

ST PCS

none

4

none

9

mild

21

mild

47

medium

38

medium

34

strong

31

strong

4

PT UP THE STAIRS

PT PCS

ST UP THE STAIRS

ST PCS

none

6

none

9

mild

24

mild

52

medium

36

medium

30

strong

28

strong

3

PT DOWN THE STAIRS

PT PCS

ST DOWN THE STAIRS

ST PCS

none

12

none

18

mild

33

mild

54

medium

31

medium

22

strong

18

strong

0

It is interesting to observe that pain registered at the start, both prior to and subsequent to treatment, lasted a lot longer in the case of the men than the women. However, the assessments show significant improvements for both genders.

Average duration of pain at the start (in seconds)

Gender

Avarage PT

Avarage ST

Men

550

333

Women

180

71

All

317

167

Significance – Men:H0: the value of pain at the start is identical prior to and subsequent to treatment.H1: the value of pain at the start is not identical prior to or subsequent to treatment.

Survey of the maximum distance of pace (cm) brought the following result:

Gender

Avarage PT

Avarage ST

Men

42

46

Women

41

44

All

41

45

Maximum distance of pace - Significance – Men:H0: the value of maximum distance of pace is identical prior to and subsequent to treatment.H1: the value of maximum distance of pace is not identical prior to or subsequent to treatment.

Significance – Women:H0: the value of maximum distance of pace is identical prior to or subsequent to treatment.H1: the value of maximum distance of pace is not identical prior to or subsequent to treatment.

Walking time both on flat ground (25 metres) and up and down 20 stairs showed improvement. Such improvement was most marked on flat ground, with lesser (although still significant) improvement in the case of walking the stairs.

On 25m of flat ground:

Men

t=5.16 tp=2.030 t>tp

Women

t=7.45 tp=2.000 t>tp

Up 20 stairs:

Men

t=6.14 tp=2.030 t>tp

Women

t=7.45 tp=2.000 t>tp

Down 20 stairs:

Men

t=6.99 tp=2.030 t>tp

Women

t=6.80 tp=2.000 t>tp

Gender

Walking time on 25m of flat ground PT (sec)

Walking time on 25m of flat ground ST (sec)

Men

46

41

Women

47

40

All

47

40

Gender

Walking time up 20 stairs PT (sec)

Walking time up 20 stairs ST (sec)

Men

47

41

Women

52

43

All

50

42

Gender

Walking time down 20 stairs PT (sec)

Walking time down 20 stairs ST (sec)

Men

55

40

Women

47

41

All

50

41

The patients’ ability to walk essentially improved upon ascending and descending the stairs. (We did not examine men and women separately.)

Prior to treatment

With both feet

With one foot

Holding on to something

Not holding on to anything

Holding on to something

Not holding on to anything

Upstairs

41

18

32

3

Downstairs

33

29

30

2

Subsequent to treatment

With both feet

With one foot

Holding on to something

Not holding on to anything

Holding on to something

Not holding on to anything

Upstairs

45

25

20

4

Downstairs

29

42

17

6

We detected improvement of a similar degree for of those requiring a walking aid in the street or at home. Of the eight patients walking with an aid at home, two were able to give it up; of the 27 people using a stick or an elbow-crutch, four were able to abandon the aid altogether.

Prior to treatment

Subsequent to treatment

With aid

Without aid

With aid

Without aid

At home

8

86

6

88

In the street

27

67

23

71

Many of the patients took non-steroid antiphlogistics regularly, primarily diclofenac derivatives. No one was taking steroids regularly among the patients examined. By the end of the treatment period, the number of those able to reduce their dose of non-steroids was significant. Moreover, in a few cases, they could even eliminate it (for men, 4 out of 20, and for women, 10 out of 38).

Upon conclusion of the treatment, we asked the patients to judge their condition pre- and post-treatment. Of the 94 patients, one person mentioned a deterioration, 30 deemed their condition practically unchanged, 20 reported a medium improvement, 31 a definitely significant amelioration, and five reported an excellent result.It is equally important to emphasise that every overseas patient declared he/she would be happy to return to Hungary for a repeated complex cure.

Acknowledgement

The authors express their thanks to Mr Tamás Varga, contributor of IT Management of Danubius Hotels Nyrt, for his assistance in data processing and for conducting the significant calculations.

Efficiency survey of complex physiotherapy cures at spa hotels for patients with coxarthrosis

The authors performed a multi-centric survey at six spa hotels belonging to Danubius Hotels Inc., as well as at the spa operating in the same building as Danubius Hotel Gellért. They studied the therapeutic results of complex cures lasting two or three weeks on 94 patients with coxarthrosis. The survey compared the condition of patients both prior to and subsequent to the treatment. For a clear majority of patients, an improvement manifested itself both objectively and subjectively.Statistical calculations were carried out on quantifiable parameters, confirming a significant improvement in every case.

We would like to inform our guests that as of 1 August 2014, the operation of Danubius Zrt's Hotel Lövér in Sopron has been transferred to an unaffiliated operator. As a result, the hotel's website may now be accessed at www.hotellover.hu

Hotel Lövér will no longer participate in any special deals or discounts pertaining to hotels in the Danubius Zrt. network, and it will not be possible to collect or redeem points in the company's frequent guest programme, nor redeem the Danubius Gift Card there.Any reservations received prior to 1 August will naturally remain valid according to the prices and conditions previously confirmed by the hotel, and frequent guest card points for these stays will also be credited accordingly.

If you have any further questions, please contact us for more information:Tel.:+36 99 888 400 | Email: info@hotellover.hu